Exercise: Key to your mental health!

“Exercise keeps me occupied, which is good for my mental health!”-Gail Porter.

Exercise ensures successful brain functioning. There is a long history of how our ancestors knew the importance of fitness and maintaining an active lifestyle. Some studies suggest that this relationship is a part of the evolutionary process as physical activity is associated with survival. There has been overwhelming evidence of how exercise helps in delaying or preventing the neurodegenerative changes in the brain and also helps in improving mental health.

How does exercise help?

  1. Depression: It is said the exercise is the most underutilized drug for depression! Various studies have supported the role of exercise to improve symptoms of depression. The reason is attributed to the secretion of neurotransmitters like serotonin and endogenous morphine which produce a state of euphoria.
  2. Anxiety: High-intensity exercise has shown to improve anxiety. 20 to 30 minutes of aerobic exercise has a positive effect. Some hypothesis behind the positive effect is increased in temperature causes a decrease in muscle tension. Another possible reason is the activation of the sympathetic nervous system causing an increase in adrenaline. This provides a catalyst for the parasympathetic nervous system and the acetylcholine released causes the calming effect.
  3. Cognitive functioning: It’s an important party of mental health and well being. Regional cerebral blood flow improves with exercise causing an increase in glucose uptake and oxygen. All this will help to improve the cerebral activity.

Incorporate 20 to 30 minutes every day and perform some sort of exercise. Aerobics in form of walking, dancing, jogging, biking. Include strengthening exercises in your routine 2-3 times per week.

It’s never too late to start exercises and continue doing them as a routine. “Sound mind resides in a sound body”!



Ways to ease mommy’s thumb

Happiness has no bounds when you cuddle and hold your baby. We read all the blogs, books and pages on the internet, to update ourselves on how to take care of the baby. But sometimes we forget to know those tips and tricks to prevent aches and pains post-pregnancy. Postpartum or post-pregnancy there are so many changes still happening in the body due to hormones.

Painful wrist and thumb are very commonly seen in new moms and even dads due to repetitive action of picking up and holding the baby, changing the diaper, putting in and out of car seat etc.

Definitely, we want you to continue doing these activities as its best way to bond with the baby, but let’s look into the causes of those aches and pains you may be having and prevent, self test and ease them before it becomes a ongoing problem.

What is Mommy’s thumb/ Dequirvain’s Tendinitis

Mommy’s thumb or Dequirvain’s tendinitis is inflammation of tendons around your thumb and wrist. Pain is typically dull achy and the area near the thumb is tender to touch. You might notice swelling, redness or warmth in acute phase.

How to self test

Check out this video to self assess the reason for your pain.

How to ease the pain

  • Icepack: Icepack works wonders in the acute phase of inflammation. If the pain is chronic for more than 3-4 weeks and you do not notice any warmth or swelling, you may use a heating pack.
  • Gentle range of motion: You do not want your thumb to get stiff. Gentle movements help to improve blood circulation and ease stiffness.
  • As pain improves start with some exercises to strengthen your finger and thumb and wrist muscles.
  • If pain is severe you may briefly use a splint or brace to prevent stress.
  • See a physical therapist, get your condition assessed properly and treat it before it becomes a chronic condition.

Tips to prevent painful thumb

Prevention is always better than cure!

  • Follow right body mechanics while lifting the baby. So instead of picking up the baby u holding under the arms by stretching your thumb out, try scooping the baby under the bottom by keeping your palms facing up and wrist neutral.
  • Follow right body mechanics while lifting the baby. So instead of picking up the baby u holding under the arms by stretching your thumb out, try scooping the baby under the bottom by keeping your palms facing up and wrist neutral.

Happy motherhood!

Why Physiotherapy does not work for everyone?

Have you ever wondered why some people say Physiotherapy did not work for them?

A big part of my clinical consultation involves talking to patients who have been struggling to recover from their injuries or Physiotherapy did not work for them in the past.

The most common reason for this could be either you are pushing yourself too much or you did not get the right Physio.

Whenever you have an injury, like any other disease or condition, you need time to recover. 

Even if it is a mild cold, it does not disappear in a day, does it? So it is the same with any musculoskeletal injury. Normally soft tissue injury can take 6 weeks or more to recover and if you have a fracture, complete recovery can take upto 12 weeks (depending on the bone you fracture).

Damage to the soft tissues(muscle, ligament, tendons) causes inflammation around that area and you can have signs like redness, warmth, swelling, pain and sometimes bruises. 

Let’s make it more simple, imagine you had a cut while working in the kitchen or deep scratch while walking in the woods. Like how these cuts or scratches do not heal in a day, likewise any other injuries need time to heal. 

If you are an active person, it becomes very hard to rest or avoid the sports or activities you love to do. However, it is very important to pace your recovery program. 

Expecting to return to sports or your regular activities too soon because the signs of inflammation have come down can be one of the greatest mistakes that you can make. Once the signs of inflammation are reduced, you need to gradually start building up muscle strength and flexibility. This will prevent excessive loading of the muscle too soon which can lead to irreparable damage.

Some patients that I talk to often refer to seeing Physiotherapists for weeks with no improvement and are just looking for surgical options. I like taking very detailed consultation with such patients as it often turns out that the Physiotherapy program that they were provided was either machine-based passive treatment or too basic or very intensive exercise program.

That is why it is very important to design a customised program as each individual is different. And that can be achieved if we listen to our patients and let them set their goals.

So if you have any ongoing or recurrent pain, please comment and connect.

Riding a tide called motherhood!

Tips from a stay at home mom, a working mother and a grandmother

Motherhood is a fusion of emotions. A mixed bag of sentiments such as joy, the feeling of accomplishments, sometimes guilt and uncertainty. But as years pass by we realize it’s all about how to balance this ride!

The month of March is dedicated to all amazing women. I got the privilege to interview three wonderful mothers. And I am excited to share their perspectives on motherhood.

Meet Pallavi Sapre 41-year-old, Mother of two and a stay at home mom

Question: How long have you been a stay at home mother and what prompted you to stay home with the kids?

Answer: I have been a stay at home mom for 14yrs. I decided to stay at home due to circumstances during and after pregnancy. I somehow couldn’t get back to work as I had my second baby.

Question: What do you think about working moms?

Answer: I have tremendous respect for working moms who can manage both work and family.

Question: What do you do all day and how you plan it?
Answer: Most of my day revolves around the girl’s schedule. Once I get my time then I do some exercise, watch T.V, read, go for a walk with friends, play badminton… etc.

Question: What is the best part of being a stay at home mother?
Answer: It has its perks. I get to stay with my kids all the time…. literally. I enjoyed each moment watching them grow, reaching each and every milestone. This is something I would love to cherish all my life.

Question: What is the piece of advice you would give to another mom who is contemplating becoming a stay at home mom?
Answer: There is no harm in becoming a stay at home mom but don’t get too comfortable with that role that you may not be able to come out of it. Enjoy it fully but at the same time keep in mind that one day you need to get back to work. This is very important as after a few years children will get busy with their own lives.

Question: What do you do to keep your mind and body fit?
Answer: For physical fitness, I play badminton, gym workouts, dance and for my mental wellbeing I go for walk with friends, read books.

Meet Nancy Hsu 42-year-old, Mother of two, Program manager.

Question:  Do you think it is easier or harder to be a working mom?

I feel its both, harder because you are juggling too many things same time. But for me personally, I feel easier as it helps me to stay mentally and emotionally healthier. 

Question: How do you manage the busy schedule, being a wife, mother and working in office?

My mother and husband help me to manage the day. I believe in taking one thing at a time and not get overwhelmed. And when things go bad just let it go.

Question: What is one thing you would like to do more often? 

Working out and having a exercise routine is something I would like to do more often.

Question: What is that one thing you would have done differently as a working mom?

I always wished to have dinner with my family which I often missed due to work and travel. This Pandemic made it possible for me to sit with my family for dinner every single day!

Question: What is the best parenting advice and relationship tips you would offer to other working moms?

Accept help if someone offers. For a successful relationship, its very important you spent quality time with your partner. Focus on what will matter to you after 10 or 20 years. It’s ok to not clean the house one day and spend time doing what you like. For me its spending time with my kids as I know they will soon go to college so each minute I want to make it a memorable one.

Question: What do you do to keep your mind and body fit?

Regular workouts, reading, watching TV, play board games with kids and spend quality time with family and friends. 

Meet Maria Damas, 72-year-old loving mother and a grandmother

Question: You raised 4 kids while your husband travelled for work?? How did you manage everything without losing your mind?

 Answer: I lived in El Salvador. My day started early at 5 AM before the kids woke up. I kept things ready for them and once they went to school I went to the gym to make sure I stay fit. While heading back home from the gym I bought fresh produce and groceries and cooked for my family homemade food. After kids were back from school remaining day was spent helping them with homework, cooking the evening meal and once the kids were off to bed I spent some time “me time” again by reading a book, watching T.V.

Question: What do you think you see parents worry too much these days?

Answer: Kids have easy access to gadgets and technology, and I feel this is what makes parents more worried as they have to be vigilant all the time. I feel back then we had more control over our kids but this might be due to cultural difference in different countries.

Question: What is your best advise to your kids at this point in their life?

Answer: To dedicate more time to kids as they are young and save money to prepare for a better future.

Question: What is your biggest piece of advice for mothers raising children today?

Answer: Discipline and sticking to the rules is very important .

 Question: What do you do to keep your mind and body fit?

Answer: I maintain my schedule and eat healthy food, I do not miss going for a walk, read books, relax and not to get involved in other people’s business.

It was a great privilege to be able to interview three powerful mothers. I realized each one of them has a very positive outlook on their choices of the role they took in their life. The stress on self-care and “living in the moment” is something that touched my heart.

I hope their outlook towards life, parenting and self-care will give you an opportunity to look into a new perspective and bring new light into your life and relationships with your family and with yourself.

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Why do I keep spraining my ankle?

This is a very common problem, and in my day-to-day practice I talk to many patients who are fed up with frequent ankle injuries. To understand this, we initially have to focus on what happens in an ankle sprain.

Normally it is the ligaments stabilising the ankle joint that are affected. The most common type of ankle sprain is where the ligament structure on the outer side of the ankle is damaged. This is termed lateral ankle sprain, and can occur when we twist our ankle outward and place excessive strain on the ligaments present around those areas – the anterior talofibular ligament (ATFL), calcaneofibular ligament (CFL), and the posterior talofibular ligament (PTFL). 

The severity of the tissue damage depends on the amount of force produced during the injury. Sources of ankle sprain include slipping off steps, stumbling on uneven ground or wearing high heeled shoes. The mechanism of the injury commonly involves the weight of the body rolling over the ankle in an unintended direction. So if your job involves wearing high heels, keeping an extra pair of comfortable flat shoes or sandals could help. You can use them intermittently to avoid continuous load over the tendons and ligaments of your ankle joint.

How can I treat a sprained ankle?

Most simple sprains will heal within two to four weeks by adhering to the following guidance:

  • Protect: Continue your day-to-day activity if you can do so without pain. But refrain from any activity that aggravates or increases your pain
  • Rest: Don’t confine yourself to bed – continue to move your ankle within its normal range of movement
  • Ice: Apply ice to your ankle for up to 15 minutes and repeat every 3-4 hours during the day
  • Compression: You can use a compression bandage to support your ankle. But remove this every few hours to allow your ankle to return to the normal range of motion
  • Elevation: Place your ankle on a cushion so it is above the height of your waist

However you may need the advice of a professional, particularly if – 48 hours after the injury – the ankle remains severely swollen, with a bluish discolouration accompanied with pain when the ankle bears weight. In these circumstances you should contact a Physiotherapist, who will advise on the appropriate level of rest or gentle recovery exercises. Alternatively, their assessment may deem the sprain to be severe enough to require a referral to a doctor.

How can I prevent ankle sprain?

Whether you are stepping out for a walk or any kind of sporting activity, it is very important to warm up and in the same way let your body cool down at the end of the session. Warming up helps to increase circulation, readying the muscle fibres so as to lower the risk of injury. 

Wearing footwear and clothing that is appropriate to your activity is one of the more obvious practices for avoiding an ankle sprain (or, indeed, various other injuries). 

‘Proprioception’ is the body’s ability to perceive its own position in space. For example, if you are running through a forest and suddenly encounter a puddle, it is your proprioception that will determine the ultimate decision made by your brain: to either jump over the puddle or take a step around the side. Whenever you have an ankle sprain, there will be alterations in your proprioception. Ankle stabilisation exercises including proprioceptive training is something that you should consider to prevent first-time or recurrent ankle injury. 

The majority of the ankle sprains I treat seem to occur in patients who have previously suffered one or more sprains. And the common factor with so many of these patients is their previous decision to put up with the pain, opting against any proper rehabilitation that would have maximised their recovery. Given the risk of recurrent sprains, it is concerning that about half of people sustaining an ankle sprain do not seek medical attention. I have many years of experience in the successful treatment of ankle sprains, and welcome contact from anyone who seeks further advice or treatment.

Muscle fever: A positive sign after exercise!

Muscle fever or Delayed onset muscle soreness (“DOMS”, to use the clinical term) is a response of the muscle to an unaccustomed exercise. Sometimes it is mistaken as a muscle strain.

DOMS occurs because of the temporary inflammation or damage to muscle fibres when they are loaded. The soreness begins a day after your exercise and usually peaks at 48 hours.

HOW and WHY does it happen?

  • Concentric (muscle is in shortened position) and eccentric (muscle is in lengthened position) exercises disrupt the structure of the muscle fibre. The effect is seen more in eccentric exercises.
  • Some studies have shown an increase in the muscle enzyme that causes muscle ache.
  • Unaccustomed exercise can cause a build-up of metabolites (a by-product of various chemical processes within the body). This build-up will force an increased pressure on our muscle tissue, with the accumulation of fluid sensitizing the nerves.

Do I have muscle fever or muscle strain?

Muscle strain causes immediate focal pain while contracting concentrically. Whereas DOMS will build over 24 hours before disappearing after 2 to 4 days.

What can I do about DOMS?

  • Active recovery: Light exercises should be performed to improve the blood flow.
  • Stretching: Gentle stretches are effective. Avoid ballistic i.e fast movements while stretching.
  • Foam roll: Gentle massaging effect of foam rolling may help to alleviate symptoms.
  • Massage: Avoid deep tissue massage. Gentle light massage may help with the draining of metabolites in the lymphatic system.
  • Wearing compression garments post-exercise can be an effective way to reduce DOMS and accelerate recovery.
  • Hydration: drink sufficient fluids before, during and after exercise to reduce the likelihood of muscle fever
  • The prevention of muscle fever is the very reason we are taught to perform warm-up and cool-down exercises before and after every fitness session.

DOMS is actually a positive sign that your muscle is recovering into a stronger state. 

Please follow the tips to improve your symptoms and let us know how it helped.

Happy exercising!